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Culture of intolerance among doctors coud drive medical excess

There is a notion in the medical community that over-testing and over-treatment of patients (i.e. defensive medicine) is practiced in order to limit the risk of future medical malpractice cases. While there may be some truth to this notion, a recent publication in The BMJ suggests that the overall culture in the medical community, as well as the attitudes among physicians may be more of a reason for defensive medicine than the specter of a medical malpractice claim.

Essentially, the culture of intolerance towards uncertainty and error among physicians themselves is the driver of over-testing and over-treatment. Doctors appear to perpetuate a culture where uncertainty in treatments is unacceptable; almost as if they have to be perfect with every diagnosis and recommendation for treatment. Indeed, there is an obvious incentive in being accurate, but when it deteriorates into medicine that does not focus on the best treatment for the patient, the culture behind it should be changed.

Because of this, two highly regarded professors argue that professional and public attitudes towards medical errors must be changed. This goes beyond medical malpractice reform, as the financial incentives presented to doctors along with the persistent marketing efforts to physicians create an increasing demand for testing and treatment.

So as long as doctors are rewarded for over-testing, and the public sentiment regarding medical malpractice continues, culture changes may be difficult. Nevertheless, the inevitability of failure or mistakes should not prevent people who have been genuinely harmed by negligent doctors from being compensated for their losses. 

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